(P328) How Well Are Online STI Treatment Providers Doing? Measuring the Impact of the BASHH Position Statement for Inappropriate Use of Multiplex Testing Platforms and Suboptimal Antibiotic Treatment.

Background:

Online pharmacies are an easily accessible method of procuring treatments for Sexually Transmitted Infections (STIs). The aim of this study was to determine whether treatments sold by online pharmacies in the United Kingdom adhere to national guidelines set by the British Association for Sexual Health and HIV (BASHH).



Methods:

Using findings from a previous study of a similar nature and Google search engine results (October 2022), a list of pharmacies offering treatments for Herpes simplex Virus (HSV), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis, Non-gonococcal urethritis and Mycoplasma genitalium, was compiled. Treatments offered were recorded and compared to BASHH guidelines.



Results:

25 pharmacies were identified, one of which was excluded for requiring video consultation.

STI	Number of pharmacies offering treatment (N=24)	Percentage of pharmacies in line with BASHH guidelines
Chlamydia trachomatis	21	100%
Herpes simplex virus	21	95%
Neisseria gonorrhoeae	4	0%
Trichomonas vaginalis	2	50%
Mycoplasma genitalium	3	33%
Non-gonococcal Urethritis	2	50%

All of the pharmacies offering treatment for NG stated that the treatment offered was not first-line. All but one (95%) of the pharmacies required an online consultation form to be completed before treatment could be bought. Despite asking if the individual has been diagnosed with a particular STI, submission of proof of diagnosis was only required by one pharmacy (4.1%). All of the pharmacies included written information about the infections for which they offered treatment, although there was considerable variation in the quality of the information provided. Partner notification, as well as partner testing, was recommended by many pharmacies.



Conclusion:

Compared with a 2017 similar study, a similar number of online pharmacies is available. Apparent improvements in practice were observed for CT and HSV, where treatment is easily available online and the regimens offered are appropriate. However, poor prescribing practice for NG remains a concern. The non-requirement for proof of diagnosis is problematic and threatens antibiotic stewardship principles. National regulation of, and direct communication with, online pharmacies may help to reduce discrepancies with national recommendations.